Issued: July 14, 2023

Reverification, also known as recredentialing, is an evaluation of a provider’s ongoing eligibility for continued participation in NC Medicaid. The Affordable Care Act requires that providers be reverified every 5 years to ensure their credentials and qualifications meet program requirements and are in good standing.

Providers receive notice of their reverification due date via the message center inbox in the NCTracks secure provider portal. For convenience, NC Medicaid offers a list of Active Provider Re-Verification Due – July 2023 – Dec 2023” dates (updated biannually).

What is happening? 

Providers must submit their reverification application under the applicable NPI by their due date to avoid suspension. The reverification due date displayed is also the health plan suspension date of the provider record if no action is taken to submit the reverification application under the applicable NPI. If the health plan is suspended, claims payment will stop.

Providers who do not complete the reverification process on time will be suspended from Medicaid program participation. If the reverification application is not submitted, NCTracks will send reminders at 50 days, 20 days and 5 days prior to the provider reverification due date. Providers will be suspended if the reverification application is not submitted by their reverification due date. The provider will be terminated from the NC Medicaid program following 50 days of suspension.

NC law requires that providers pay a $100 fee for Medicaid reverification.

When is this happening?

Ongoing based on listed due date: Active Provider Re-Verification Due – July 2023 – Dec 2023

What do providers need to do?

  • Providers should frequently check their Provider Message Inbox for notifications or the reverification section of the Status and Management page in the NCTracks Secure Portal for the option to reverify.
  • Providers should submit the reverification application by their due date.

What if providers have questions? 

Providers may contact the NCTracks Call Center at 1-800-688-6696 for assistance.